Revlimid for prostate cancer.

Much research had gone on about the effects of thalidomide and the related drug Revlimid on prostate cancer. Thalidomide is listed by AHFS for prostate cancer. Revlimid is closely related to Thalidomide, but is better tolerated and a number of studies have suggested that it is of benefit in hormone resistant population. 
There is an ongoing study of 2 Different Doses of Revlimid in Biochemically Relapse Prostate Cancer, NCT00348595 

The primary objectives of the study are:

•To evaluate feasibility, safety and tolerance of 6 months administration of Revlimid at 5mg/day and 25mg/day, given orally in subjects with prostate cancer with evidence of biochemical relapse (M0) following local treatment (i.e., surgery or radiation).
•To assess the rate of PSA progression at 6 months after treatment with 5mg/day and 25mg/day of Revlimid (CC-5013) in patients with evidence of biochemical relapse after local therapy.

A recent report in ASCO 2010 showed “preliminary activity”. It is also recently reported IN ASCO 2011 to be active in a multidrug regimen that includes Avastin (bevacizumab), docetaxel and prednisone in patients with metastatic castration-resistant prostate cancer.

At this time, Revlimid should be considered investigational and therefore not medically necessary for prostate cancer.

S. Smith, B. I. Rini, T. Gilligan, D. Peereboom, P. Elson, E. Klein, R. Dreicer Abstract Phase I/II study of lenalidomide and GM-CSF in hormone refractory prostate cancer (HRPC). No: 229 2007 Prostate Cancer Symposium 

Figg WD, Dahut W, Duray P, Hamilton M, Tompkins A, Steinberg SM, Jones E, Premkumar A, Linehan WM, Floeter MK, Chen CC, Dixon S, Kohler DR, Kruger EA, Gubish E, Pluda JM, Reed E (2001) A randomized phase II trial of thalidomide, an angiogenesis inhibitor, in patients with androgen-independent prostate cancer. Clin Cancer Res 7: 1888–1893

C. Nabhan, K. Tolzien, S. K. Kelby, T. M. Lestingi; Oncology Specialists, S.C., Park Ridge, IL Single-agent activity of lenalidomide in chemotherapy-naïve castration-resistant prostate cancer (CRPC). ASCO 2010, 161

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